Abstract:

Five ports placement was employed. Transverse colon was retracted cranially by the assistant surgeon. The peritoneum was incised at the cranial side of the ileocolic pedicle, and transverse incision was made alongside the ileocolic pedicle. Superior mesenteric vein and artery were exposed respectively. The middle colic artery was separated, and then No. 223 lymph nodes dissection was done followed by the ligation of middle colic artery at its root. Upward dissection of the peritoneum above the SMV was performed until meeting the neck of pancreas. During this upward dissection, the middle colic vein was ligated and cut at its root, and the Henle trunk and its branches were exposed, with the ligation of right colic vein and right gastro-omental vein. The prepancreaticduodenal space was extended behind the transverse colon. The splenic flexure was mobilized from 3 directions, and the inferior mesenteric vein was preserved. 10cm from tumor proximally and distally was identified, and the removal extension of the gastro-omental artery was measured with the dissection of No. 204 and No. 206 lymph nodes. Then the hepatic flexure was mobilized. Umbilical port was extended vertically for specimen harvest and the proximal and distal colon segments were reconstructed extracorporeally with functional end-to-end anastomosis by linear stapler.

Key words: Colonic neoplasms, Laparoscopy